Free Subscription Request

New Subscriber Renewal Address Change
Name
Company
Address
City State Zip
Phone (xxx) xxx xxxx
Fax (xxx) xxx xxxx
Email you@yourISP.com

1

I wish to receive RICE FARMING free of charge

YES!
No.

Today's Date mm/dd/yyyy

2

BUSINESS ACTIVITY:
Rice Farmer
Land Owner
Drier
Miller

I grow
acres of Rice
acres of Soybeans

3

FOR AGRIBUSINESS:
I am in agribusiness. My primary business is:
Crop Consultant
Chemical Dealer
Aerial Applicator
Equipment Dealer
Chemical Manufacturer
Seed Company
County/Extension Agents
Other (please specify)

4

For auditing verification purposes only: what is the City/Town of your birth?

5

Yes No Do you want to receive emails with industry news?
Yes No Do you want to receive emails from us about special events or product offerings?
Yes No Do you want to receive emails from suppliers about products/services we think you will find valuable?

You may also print out this form and fax it to 229-386-8224 or mail it to the following address:

Rice Farming
Subscription Service Center
P.O. Box 7627
Tifton, GA 31793-7627